Choosing lipid lowering statin in risk strategy of cardiovascular event prevention
Abstract
Aim. To investigate low density lipoprotein cholesterol (LDL-CH) lowering effectiveness of atorvastatin (Torvacard; 20 mg/d) in patients with moderate hypercholesterolemia (HCH) after 4 and 12 weeks of treatment, together with standard hypolipidemic diet; to assess (%) target LDL-CH level achievement (<2,5 mmol/l, or 100 mg/dl) in patients of very high cardiovascular risk (risk category 1), receiving atorvastatin (Torvacard; 20 mg/d) for 12 weeks.
Material and methods. The trial included 32 patients (20 men aged 40-68 years, 12 women aged 54-67 years). At baseline, all participants had LDL-CH level >3,4 mmol/l (130 mg/d) despite previous standard hypolipidemic diet for at least 4 weeks. Maximal LDL-CH level was as high as 4,5 mmol/l (175 mg/dl).
Results. Tovacard lipid-lowering effect was completely manifested after 4 weeks: total CH level decreased by 32%, and at week 12 by 33%. LDL CH levels reduced by 44% and 46%, respectively. High density lipoprotein CH level increased by 6,3% at week 12. Plasma triglyceride levels decreased by 14% and 24% at weeks 4 and 12, respectively.
Conclusion. Tovacard (20 mg/d) demonstrated high lipid lowering effectiveness. Atorvastatin generic, Torvacard, could be included into out-patient clinic medicine lists as an effective statin with optimal cost effectiveness and no need for dose titration.
About the Authors
A. Ya. YvlevaRussian Federation
L. A. Alekseeva
Russian Federation
N. M. Poluboyarova
Russian Federation
References
1. Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344: 1383-9.
2. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20536 high-risk individuals. Lancet 2002; 360: 7-22.
3. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-then-average cholesterol concentrations, in Anglo-Scandinavian Cardiac Outcomes Trial Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet 2003; 361: 1149-58.
4. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and other Societies on cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 2003; 24: 1601-10.
5. Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации. Москва 2004.
6. Connie B, Palmer G, Silbershatz H, et al. Safety of atorvastatin derived from analysis of 44 completed trials in 9416 patients. Am J Cardiol 2003; 15: 670-6.
7. Nissen S, Tuzcu M, Schoenhagen P, et al. Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis. JAMA 2004; 3: 1071-80.
8. Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more then 80%. BMJ 2003; 326: 1419.
9. Smith DG, Leslie SJ, Szucs TD, et al. Cost of treating to a modified European Atherosclerosis Society LDL-C target. Clin Drug Invest 1999; 17: 185-93.
Review
For citations:
Yvleva A.Ya., Alekseeva L.A., Poluboyarova N.M. Choosing lipid lowering statin in risk strategy of cardiovascular event prevention. Cardiovascular Therapy and Prevention. 2007;6(1):54-60. (In Russ.)